Employment Application

BAY AREA MEDICAL EXCHANGE, INC
PRELIMINARY INTERVIEW QUESTIONS
Do you have dependable transportation to get to our Clearwater, FL office? *

Yes No

BAY AREA MEDICAL EXCHANGE, INC
Because we are a 24/7 company, working a flexible schedule is a part of the job. Do you understand and agree that you are able to work within a designated 12-hr window of availability? (Ex: Availability 10AM-10PM, 2PM-2AM, etc.) *

Yes No

BAY AREA MEDICAL EXCHANGE, INC
WORK PREFERENCES

NOTE: We staff our office to meet the needs of our clients. In our industry, please be aware the busiest times and greatest staffing needs include weekends,evenings, and holidays.
Please select any & all time frames for which you can be available to work *

Early AM (4 am – 6 am) Mornings (6 am – Noon) Afternoons (Noon – 5 pm) Nights (5 pm – 8 pm) Late Night (8 pm – Midnight) Overnight (Midnight – 5 am)

BAY AREA MEDICAL EXCHANGE, INC
REFERENCES

List three personal references that are NOT related to you and are NOT previous employers:
FIRST REFERENCE INFORMATION *
SECOND REFERENCE INFORMATION *
THIRD REFERENCE INFORMATION *

BAY AREA MEDICAL EXCHANGE, INC
WORK EXPERIENCE

List your present or last job FIRST. Include military service assignments & volunteer activities. Exclude organizational names which indicate race, color, religion, or national origin.

BAY AREA MEDICAL EXCHANGE, INC
APPLICANT STATEMENT

I certify that the answers given herein are true & complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not and is not intended to be a contract of employment. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the company.
Last 4 of Social Security #
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By sumbitting this application, you agree to the Applicant Statement above.

BAY AREA MEDICAL EXCHANGE, INC
Thank you for your interest in applying for a position at our company.

Unfortunately, we cannot accept your application at this time because most positions with Bay Area Medical Exchange, Inc. require employees to have reliable transportation and/or be able to work flexible hours, including weekends and holidays.

Should your situation change, we welcome you to visit our website again and re-apply. Thank you!
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BAY AREA MEDICAL EXCHANGE, INC